Forms and Applications
Enrollment Forms and Applications
The Student Insurance Appeal form will be available until October 31st. Please complete and submit to the school as directed.
All documents are in .PDF format. In order to read and print your enrollment form, you will need to have Adobe Reader downloaded and installed on your computer. You may click on the image below to download Adobe Reader.
Protect what's yours.
Considering purchasing a high-deductible insurance plan instead of your school's sponsored plan?
- Gallagher Student Health & Special Risk
500 Victory Road, Quincy, MA 02171
- Toll Free